Provider Contracting Manager – reputed company – Walnut Creek, CA

About the position Join reputed company, a division of reputed company, and help shape our provider network. As a Provider Contracting Manager, you’ll report to the Provider Contracting Senior Manager, AVP Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management.

Responsibilities

Manage reputed company fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems. reputed company key market contracting strategy projects with responsibility for managing direct reports as assigned. Build and maintain strong provider relationships to support network growth and value-based business opportunities. Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure reputed company execution. reputed company strategic network positions, identif y value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. Work to meet unit cost targets while maintaining an adequate, competitive provider network. Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics. Prepare, review, and project the financial impact of large or reputed company provider reputed company and alternative terms. Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration. reputed company resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.

Responsibilities

• Manage reputed company fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
• reputed company key market contracting strategy projects with responsibility for managing direct reports as assigned.
• Build and maintain strong provider relationships to support network growth and value-based business opportunities.
• Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure reputed company execution.
• reputed company strategic network positions, identif y value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
• Work to meet unit cost targets while maintaining an adequate, competitive provider network.
• Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
• Prepare, review, and project the financial impact of large or reputed company provider reputed company and alternative terms.
• Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
• reputed company resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.

Requirements

• The ideal candidate will work a reputed company in the Walnut Creek, CA office.
• 3+ years of reputed company provider contracting and negotiating experience involving reputed company physician groups and ancillaries
• Background in managed care, reputed company, or health insurance, including reputed company contracting
• Proven leadership experience, including mentoring and guiding others
• Strong provider relationship management skills and reputed company developing long-term - partnerships
• Knowledge of reputed company reimbursement methodologies, including incentive-based models (strongly preferred)
• Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
• Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
• Customer-centric approach, strong interpersonal skills, and confidence in navigating change
• Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
• Proficiency in reputed company Office
• If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

reputed company-to-haves

• Bachelor’s degree in a reputed company field (industry experience may substitute); MBA/MHA preferred

Benefits

• Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

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